On many levels, Medicare is a fraud and a hoax. So it is no surprise that the
current debate, and the way the debate is reported, is not about whether
Medicare delivers medical care at all, let alone its availability or quality.
Many politicians value Medicare exclusively as a weapon to be used to keep
them in office.

The starting point of a policy discussion should not be dramatized in a
television ad that shows the chairman of the House Budget Committee literally
throwing an old lady in a wheelchair off a cliff. That attack was on a
congressman who proposed no changes whatsoever in Medicare for anyone
currently in the system or older than 54. The argument is simple: "Anyone who
wants to change Medicare wants to kill you." Yet proponents of the current
Medicare system want all seniors to rely upon it exclusively, even though they
say the whole system could be obliterated as the result of an election--an odd
way to make the case for trust in government to meet all of our needs.

Where does that leave the debate? On one side are those for whom Medicare is
an end in itself. Their goal is to protect a one-size-fits-all institution, a
bureaucracy and a spoils system, rather than maintain or improve the quality
of medical care. On the other side are those who might push Medicare reform in
the right direction: more freedom, more choices for seniors, more competition.

But the reformers say their goal is to "save" Medicare. Why? Can't we have
medical care without 100,000 pages of federal regulations?

We must reject Medicare that claims to pay for everything while rapidly
setting up new boards and commissions, whose purpose is to eliminate benefits.

We must reverse the gradual destruction of Medicare Advantage plans. The
millions of seniors who flocked to them must be allowed to pursue these
limited private options until they prove their worth and replace Medicare.

We must reject those who claim that seniors love Medicare while the government
takes social security payments away from any senior who does not sign up for
Medicare Part A insurance.

These outrages are perpetrated by regulatory fiat. While they are being
challenged in court, the first reform of Medicare should be legislation to
force congressmen to cast a vote on whether they will continue to allow taking
Social Security away from seniors who do not sign up for Medicare Part A.
Would they dare to vote against it? If they pass such legislation would any
president dare to veto it? Simple justice requires us to find out.

Besides forcing citizens to rely on government as the only source for their
medical care, congressmen also love to force physicians to become, in effect,
public employee unions that crawl hat-in-hand to lobby for adequate
reimbursement. We must eliminate the annual ritual by which Congress votes to
temporarily delay severe cuts in Medicare reimbursements to physicians and
other health care providers to levels below their costs.

The political priority is and always will be a spoils system. Politicians
struggle to make us believe that they are not just the best but the only
permissible source to meet all of our needs. Forget freedom, autonomy, self-
reliance or independence. Their goal is universal dependence on them and
perpetual growth in government until it consumes everything.

We must reject both sides that want to "save" Medicare. What we need are
reforms that will save us all from Medicare.